Echocardiographic Findings in HIV Positive Children on Anti-retroviral Therapy Attending Routine Outpatient Infectious Disease Clinics in the Niger Delta Region of Nigeria

Abstract

Background: The aim of this study was to investigate the echocardiographic findings of stable HIV positive children on Highly Active Anti-retroviral Therapy (HAART) attending routine Paediatric Infectious disease clinics in the Niger Delta region of Nigeria. Methods: Over a 3 month period (1st October to 31st December 2019) 71 apparently stable HIV positive children who had been on HAART for at least 3 months had a transthoracic echocardiogram done after written informed consent. A proforma containing their clinical and socioeconomic information and the echocardiographic findings was filled. Data was entered into an Excel spread sheet and analysed using SPSS 22.0. Results: Among the 71 children studied, 34 (47.89%) were aged 6 – 10 years, 42 (59.15%) were females while 15 (26.01%) belonged to social class 3. Of the 71 participants studied, forty-four (61.97%) had abnormal echocardiographic findings on echocardiogram. Mild pulmonary regurgitation was the commonest finding and occurred in 32 (45.07%) of the patients. This was followed by Left Ventricular diastolic dysfunction (LVDD) which occurred in 9 (12.68%) patients, while Left Ventricular systolic dysfunction (LVSD) and Congenital heart defects occurred in 6 (8.45%) subjects each. There was no significant association between occurrence of echocardiographic findings and age, gender, duration of HIV disease, type of HAART and stage of disease at diagnosis and at the time of the study (p<0.05). Conclusion: This study shows that mild pulmonary regurgitation is the commonest echocardiographic finding among stable HIV patients followed by left ventricular dysfunction. Routine baseline and intermittent echocardiography are recommended for initial evaluation and continued care for early detection and quick intervention of cardiac diseases of children with HIV disease.